After Delaying Vote, GOP Leaders Scramble To Save Health Care Bill

Republican leaders in Washington are scrambling to save their bill to repeal and replace the Affordable Care Act. The House of Representatives was supposed to vote on the health care bill today, but with Republicans divided over just how far they should go with their changes, the vote was postponed. NPR congressional correspondent Susan Davis is following all this at the Capitol. Hi there, Sue.

SUSAN DAVIS, BYLINE: Hey, Kelly.

MCEVERS: So a lot is still happening there. Tell us. What's the latest?

DAVIS: So the latest is House Republicans are actually gathered right now in the basement of the Capitol. They're about to break up because the House is going back into session, and the White House is putting pressure to bear on Republicans. His budget director, Mick Mulvaney, a former congressman, was inside the room meeting with Republicans.

And my sources inside the room told me that Mulvaney's message to Republicans was very clear. President Trump wants a vote, and he wants a vote tomorrow - and that he told Republicans if they do not pass this, if they let it fail, there will be a political consequence, and they will be to blame for letting Obamacare stay in place, which - obviously they do not support the Affordable Care Act. But right now it's not clear that they still have - that they even have the votes to pass...

MCEVERS: Right.

DAVIS: ...The bill that they're trying to bring to the floor tomorrow.

MCEVERS: But it sounds like the president is just OK with that. If they don't have the votes, they don't have the votes, and they move on.

DAVIS: Yeah, and I think there's - part of this is the strategy that they think that maybe they have to win it on the floor if they can pass it, that a lot of people are talking and saying they don't want to vote for it. But when you are forced to take that vote on the floor, that using that pressure - the pressure of the president of the bully pulpit and the pressure from the speaker to say, look; this is party politics; this is party unity, and we've been telling voters for the better part of the past decade that this is what we were going to do if you gave us control of Washington.

MCEVERS: Let's talk about how we got here in the first place. You've got Republicans on the right who didn't like the bill for certain reasons. You've got moderate Republicans who didn't like it for other reasons. Catch us up on how we ended up here.

DAVIS: So the core opposition right now 'cause we should say Democrats are not going to vote for this bill, so this is an entirely Republican problem - the far-right conservatives, hardline conservatives in the House - there's probably about 30 of them - don't like the bill because they say it doesn't do enough to repeal the Affordable Care Act, and it doesn't do enough to lower premiums. They want more assurances that insurance premiums on people are going to go down, and they don't have that right now.

On the other end of the spectrum, more moderate, maybe mainstream conservatives or just business conservatives look at this bill and see what it does to Medicaid and recipients on Medicaid, and that's a tough vote for a lot of members particularly who come from districts with older Americans, with lower or lower-income Americans who this bill right now, you know, according to Congress's own budget analysis, says, we could see rising costs on those people in particular.

So there's - this bill's still under negotiation. It has not been reported out. We don't know what the final bill's going to look like, but it looks like it is shaping up for a vote tomorrow.

MCEVERS: And the whole thing was supposed to be this test of, you know, the relationship between President Trump and House Speaker Paul Ryan. You know, they've been saying all along that they're unified on this. If it falls apart, what does that mean about their relationship and their ability to get things done?

DAVIS: Right, and who's to blame for this because...

MCEVERS: Yeah.

DAVIS: ...On the on the substance of it, this is the speaker's brainchild. The ideas in this bill are his almost entirely. He's been one of the most passionate advocates for this bill. The way it reshapes Medicaid is something he's been trying to do his entire career. So his reputation is on the line. On the other end, you know, President Trump ran a campaign and won an election on being a dealmaker, on being someone who could close a deal and...

MCEVERS: Yeah.

DAVIS: ...Could work to change - shake up Washington. And so if he can't get members of his own party to vote for his agenda, it's not a very good sign for what's to come for him in Congress this year, particularly with other ambitious things like trying to rewrite the tax code.

MCEVERS: So we're - we hear that President Trump wants to force a vote. How soon could that happen, and what's that going to look like?

DAVIS: So they're going to come in tonight. They have to - will have a couple test votes to see where people are feeling about this. And you know, if the president wants a vote tomorrow, the leadership can make that happen. What's happening tonight and probably through the night is that faction of conservatives and this group of moderates - they're going to maybe try and meet tonight. White House - senior White House staff is on Capitol Hill trying to win these votes. People have been in and out of the speaker's office all night long. It is a very fluid situation, and it's really the biggest test of the speaker's career as - in the speaker to date and a really important test for the president and to see how - what his words means on Capitol Hill.